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It’s been 21 years since Marvin Gaye released his timeless masterpiece album “What’s going on?”. Those who work in the health sector probably ask themselves that very question daily. After all, this is the NHS; there’s always change.

The newest major change follows the passage of the Health and Care Act (2022). 42 Integrated Care Systems (ICSs) have now been established across England as statutory bodies. ICSs are designed to transform and improve healthcare through coordination of different organisations to deliver joined-up services. The aim is to provide a person-centred service that meets expectations of how high-quality care should look and feel in the twenty-first century. ICS’s are expected to improve outcomes, tackle local health inequalities, and provide good value for money.

It’s a bit Deja-vu really, the ICS model isn’t too dissimilar to the former Primary Care Trust structure where 164 of those were formed between 2000 and 2004. The real difference is that Local Authorities are now key stakeholders in health with a seat at the Integrated Care Board (ICB), so have a key input into planning and funding. There’s been many NHS Trust projects that have stalled when seeking Local Authority input/ assistance/ buy-in; hopefully alignment of interests can now drive efficiency, especially in relation to estate footprint. The key to success as ever, will be leadership and how ICB members work together towards a common goal.

The Problems of Fragmented Care

ICSs are tasked with addressing healthcare fragmentation. Often patients experience healthcare services across a range of different professionals and providers. Too often, communication between different providers is inadequate and consultants or treatment staff may not have adequate knowledge to form a holistic picture. Plus, with different plans and priorities, different healthcare organisations may be unintentionally at odds with each other, to the detriment of patient care. Fragmented care makes it difficult to provide consistently high-quality services and patients may feel their personal needs are not being addressed.

The Value of Partnership

ICSs address these difficulties by forming partnerships between organisations. These partnerships can then communicate effectively to plan and deliver person-centred health and care services for a given area. The main purposes of ICSs are to do the following:

• Improve the general health of the population and increase healthcare standards.
• Tackle inequalities in outcomes, experience and access to healthcare.
• Improve children's and young people's health.
• Care for the complex needs of ageing patients.
• Act faster to address 'preventable conditions'.
• Support those with long-term mental health conditions.
• Maintain general good health and independence.
• Foster improved productivity and value for money.
• Support the NHS's broad social and economic development goal.

How Integrated Care Systems Are Delivered

ICSs are constituted by an Integrated Care Partnership (ICP), Integrated Care Board (ICB), Local Authorities, place-based partnerships and provider collaboratives.

ICPs are responsible for developing the overall strategy, which addresses what needs to be done to meet the health and care requirements of the local population.

ICBs develop practical plans for the health needs of the community. These plans address issues like budgeting and service provision, as well as cultural issues and healthcare inequalities that could affect access to healthcare. Since the establishment of NHS Integrated Care Boards, Clinical Commissioning Groups are no longer required and are being closed.

Local Authorities are tasked with providing social care and public health measures through place-based partnerships.

Place-based partnerships engage with more detailed plans and designs for healthcare services in particular localities. These partnerships consist of many parties, including the NHS itself, local councils, voluntary bodies, residents, service users and carers, plus others.

Provider collaboratives are intended to improve the efficiency and quality of outcomes across different ICSs. They will develop the benefits of working on a larger scale than individual ICSs, helping to address regional inequalities in access and healthcare provision.

Next Steps

SilverRed are public sector property consultants and estate strategy specialists. We support NHS Trusts to make informed estate strategy decisions to deliver their ICS/ ICB objectives. To find out more, please call 07500 704290 today.

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